Summary
Chapters 7 and 8 of Madness and Civilization get us to the final stage in Foucault’s understanding of the transformation of madness in the classical age: the stage in which madness begins to be seen as something that needs to be confined in its own special way apart from other vices or deviancies like poverty. In Chapter 7, “The Great Fear,” Foucault begins by discussing the rise, in the mid-1700s, of a “great fear” about hospitals and houses of confinement in general. People started to worry that these places were breeding evil as much as confining it, so that society might soon be infected by the bad things that were concentrated there. But you couldn’t just get rid of the confinement. Instead, you had to find a way to “neutralize” the evil that resided there.
Thus, a new effort emerged to reform hospitals, especially to get rid of the evil imagined there. As part of this effort, there emerged a special attention to madness apart from simple crime, as it was madness that people came to fear was contagious. Madness seemed new, while crime seemed to have been around forever. Thus, new theories emerged about why madness was becoming more pervasive. Madness started to seem a contemporary and historically contingent problem, distinct from a universal condition of mankind.
The new theories of madness’s historical specificity came in a few varieties. First, madness was tired to liberty, or a kind of hedonism where people always desired more and more and so went mad. Second, it was tied to changes in religion, which represses people’s desires and so alienates them from the present. Third, madness was tied to the rise of civilization itself. As knowledge and science have gotten more complex and abstract, people start living more in their minds than in their bodies. This alienates people from the world, leading to madness. Indeed, in all three cases—liberty, religion, and civilization—madness is understood as people losing a sense of self because of outwardly directed desires and abstractions.
Notice how far the conception of madness has come since the beginning of this book. In an earlier period, madness was tied to animality, or original sin. These were seen as always latent in a person, and so madness was a descent into a deep, dark core of a person. In contrast, by the end of the 1700s, madness is about getting outside of one’s self instead of getting closer to a dark core. Madness emerges when man is distanced from himself. Unchecked desire, religious repression, and abstraction and knowledge all contribute to this.
This also contributed to the differentiation of the madman and the prisoner and in particular how to treat them, as Foucault looks at in Chapter 8, “The New Divison.” You might think people wanted to treat the mad better than prisoners, as the mad couldn’t help themselves, whereas the prisoners had intentionally committed crimes. But in the 1700s it was precisely the opposite. If madmen were diseased and possibly contagious, then it was prisoners who had to be protected from them. Thus, the mad were separated from the prisoners in order to save the prisoners. But this also meant that the larger category of “unreason” which had collected all the deviants together—the vagabonds and the mad and the poor and the criminal—was now torn apart. Madness became its own thing, and a special threat that needed special confinement.
Alongside this isolation was a transformation in how people thought about poverty. Remember that the hospitals were originally created to confine the poor, and the mad and others got swept up along with them. But in the 1700s, people began to think of poverty more as an economic necessity than an individual moral failure. It was just a fact of modern capitalist societies that people were going to be unemployed at any given time. But industrial societies also required as much labor as possible. So instead of jailing the unemployed, they should be put back into circulation to take up as many jobs as are available. Thus, it made no sense to confine the poor: both because you want as many laborers as possible and because, even if there wasn’t enough labor to go around, it wasn’t the poor’s fault.
This meant that the only ones who were left in the hospitals were the mad, who still had to be confined and isolated lest their madness spread to others. Mass confinement was over. But the singular confinement of the mad persisted. In fact, confinement now serves no other purpose than detention of the mad, and confinement and madness start to go hand-in-hand.
Analysis of Chapters 7 – 8
In the previous few chapters, we saw how madness developed from something that is described by language—by the ways people talk about madness—to something that manifests as language—in the way the “mad” do not obey grammatical laws that speak to their grasp of logic. So there is a discourse about the mad and then a discourse of the mad. Now, we’re seeing something similar go on in relation to confinement. At first, madness was confined. Now, madness is confinement itself, a locking of one’s brain in which you are cut off from the world. Confinement is both a physical reality and a metaphor for a psychological state.
Another theme from the previous chapters was how it is difficult to disentangle physiological and psychological causes of madness during the classical period, because the concept of the psychological did not yet exist. Foucault warns us against making distinctions based on our own systems of knowledge today rather than understanding history on its own terms. A similar thing is going on now in differentiating different kinds of “social ills.” At first, poverty, criminality, and madness were all contained together, forming one big category. But now, madness is starting to be differentiated from these things. It is still influenced by other concepts, especially the sense that, like the unemployed, the mad are not contributing to society. But madness now has its own features and requires its own forms of treatment.
Notice again the relation between power and knowledge. As a new concept is formed—new knowledge—new systems of power are also formed. Thus, as madness differentiates from poverty and criminality, it requires its own regimes of confinement and disciplining. New ways of categorizing people create new opportunities for the exercise of power.
A theme throughout these chapters is that history is not always progressive. We sometimes think things “get better” as history goes along, or that humanity becomes more civilized. With this assumption, we might, at first, think that separating the mad from the prisoners was a way of treating the mad more humanely. After all, they didn’t intentionally commit a crime; they couldn’t help themselves. Foucault’s stunning revelation is that, at first, people thought it was the criminals who needed to be protected from the mad, not the other way around. This is because of the special attention given to madness as a unique threat, related to the emergence of new knowledge about it. So the separate confinement of the mad is political rather than philanthropic, repressive rather than liberatory.
The other layer of irony in these chapters is about the relation between madness and civilization itself. We tend to think of civilization as a march to more logical thinking and ordered systems. Thus, madness should disappear as civilization progresses. Foucault points out, on the contrary, that civilization requires concepts of madness in order to make sense, so it starts talking about madness more and more. Furthermore, people start thinking madness is an effect of civilization, rather than something it represses. This is because modernization alienates people from each other and their own bodies, leading to madness in which people are out of touch with the world. So there is a paradox at the heart of these chapters and indeed at the heart of Foucault’s title, Madness and Civilization: madness is both alien to, and a product of, civilization.
